NPIMap

Organization Active NPI

Mineral Area Psychiatric Services LLC

  • Psychiatry Physician
  • Farmington, MO
National Provider Identifier
1306379482
Registry record updated Dec 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MINERAL AREA PSYCHIATRIC SERVICES LLC
Practice address
203 S Washington St
Farmington, MO 63640-1836
Phone
(573) 664-1047
NPI assigned
Apr 6, 2017
Last updated
Dec 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Gabriel E Crawford, PMHNP-BCNPI 1730546243
Title
Pmhnp
Phone
(573) 330-6468

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

203 S Washington St
Farmington, MO 63640-1836

Mailing address

203 S Washington St
Farmington, MO 63640-1836
Phone (573) 664-1047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170524002469 MO Part B Supplier - Clinic/Group Practice 3072880962 Receives reassigned benefits from 15 practitioners
Practice locations: Farmington, MO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735430400000",
    "number": "1306379482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S WASHINGTON ST",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401836",
            "telephone_number": "573-664-1047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 S WASHINGTON ST",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401836",
            "telephone_number": "573-664-1047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINERAL AREA PSYCHIATRIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-06",
        "last_updated": "2024-12-29",
        "certification_date": "2024-12-29",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "573-330-6468",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.